CLEAR COVERAGE HYSTERECTOMY CHECKLISTS

Size: px
Start display at page:

Download "CLEAR COVERAGE HYSTERECTOMY CHECKLISTS"

Transcription

1 CLEAR COVERAGE HYSTERECTOMY CHECKLISTS Click on the link below to access the checklist sheet. Abnormal Uterine Bleeding Adenomyosis Chronic Abdominal or Pelvic Pain Endometriosis Fibroids General Guidelines Pelvic Inflammatory Disease or Tubo-Ovarian Abcess Uterine Prolapse

2 ABNORMAL UTERINE BLEEDING NOTE: This checklist is intended to be used as a guideline to assist non-clinical staff in requesting preauthorizations through Clear Coverage. It is not to be used as a form for faxing information to the health plan regarding a preauthorization request. This does not guarantee authorization Abnormal uterine bleeding Premenopausal Postmenopausal Vagina and cervix normal by physical exam Most recent cervical cytology normal (or treated) PREMENOPAUSAL ONLY (see next page for postmenopausal): Thyroid disease excluded (by history, physical exam or testing) HCG planned prior to procedure; OR Sterilization by history; OR Sonohysterogram or ultrasound negative for endometrial lesion Bleeding interferes with ADL s; OR Anemia unresponsive to iron treatment > 12 weeks Treatment: Progestin or oral contraceptive pill x 3 consecutive cycles; and/or Levonorgestrel-releasing intrauterine system; and/or Tranexamic acid x 3 consecutive cycles; and/or Endometrial ablation or resection

3 ABNORMAL UTERINE BLEEDING Continued bleeding after treatment Age > 45 Endometrium normal By endometrial biopsy; and/or By hysteroscopy with D & C POSTMENOPAUSAL ONLY: Endometrium normal within last 3 months by biopsy and ultrasound Currently taking hormone replacement therapy Continued bleeding after, Change in hormone replacement therapy; OR Discontinuation of hormone replacement therapy

4 ADENOMYOSIS Adenomyosis suspected by imaging Symptoms: Pelvic or abdominal pain or discomfort and other etiologies excluded; OR Urinary frequency or urgency and other etiologies excluded; OR Dyspareunia Abnormal bleeding and if so: Vagina and cervix normal by physical exam Other etiologies of bleeding excluded AND: Bleeding interferes with ADL s; OR Anemia unresponsive to iron treatment > 12 weeks Treatment: NSAIDS > 8 weeks; OR GnRH agonist > 8 weeks; OR Depot or oral contraceptive pill > 8 weeks Continued symptoms/findings after treatment Most recent cervical cytology normal or treated per guidelines

5 ADENOMYOSIS HCG planned prior to procedure; OR Sterilization by history; OR

6 CHRONIC ABDOMINAL or PELVIC PAIN Chronic abdominal or pelvic pain of unknown etiology History and physical examination completed CBC normal Urinalysis or urine culture normal Cervical cytology normal (or treated) HCG planned prior to procedure; OR Sterilization by history; OR Ultrasound non-diagnostic for etiology of pain Testing non-diagnostic for etiology of pain: CT or MRI; and/or Diagnostic laparoscopy Treatment: NSAIDS > 4 weeks Depot or oral contraceptive > 8 week GnRH agonist > 8 weeks Antibiotic treatment X one course Continued pain after treatment

7 ENDOMETRIOSIS Endometriosis by laparoscopy Treatment: GnRH agonist > 8 weeks; and/or Depot or oral contraceptive > 8 weeks; and/or Danazol > 8 weeks Continued symptoms after treatment Most recent cervical cytology normal (or treated) HCG planned prior to procedure; OR Sterilization by history; OR

8 FIBROIDS Fibroids by Ultrasound Premenopausal Postmenopausal Symptoms: Uterine size doubled by ultrasound within 1 year; OR Ureteral compression by imaging; OR Pelvic or abdominal pain or discomfort and other etiologies excluded; OR Urinary frequency or urgency and other etiologies excluded; OR Dyspareunia; OR Abnormal bleeding, and if so: Vagina and cervix normal by physical exam; AND Other etiologies of bleeding excluded AND: Bleeding interferes with ADL s; OR Anemia unresponsive to iron treatment > 12 weeks Most recent cervical cytology normal or treated per guidelines If premenopausal: HCG planned prior to procedure; OR Sterilization by history; OR

9 Premenopausal Postmenopausal Diagnosis and/or chief complaint: Chronic abdominal or pelvic pain of unknown etiology Endometriosis by laparoscopy Abnormal uterine bleeding Adenomyosis suspected by imaging Fibroids by ultrasound Uterine prolapse Pelvic Inflammatory Disease (PID) Tubo-ovarian abcess Symptoms/Findings/Testing: History and physical examination completed CBC normal Urinalysis or urine culture normal Pelvic pressure Pelvic pain or discomfort and other etiologies excluded Acute Pelvic Inflammatory Disease > 2 episodes by H & P exam

10 Abdominal tenderness Persistent adnexal mass Temperature > Tubo-ovarian mass by imaging WBC > normal Stress incontinence Urinary frequency or urgency (other etiologies excluded) Ulceration with bleeding or spotting by physical exam Vaginal splinting Uterine size doubled by ultrasound within 1 year Ureteral compression by imaging Dyspareunia Abnormal bleeding, and if so: Vagina and cervix normal by physical exam Other etiologies of bleeding excluded Bleeding interferes with ADL s Anemia unresponsive to iron treatment > 12 weeks Most recent cervical cytology normal (or treated) Negative HCG HCG planned prior to procedure Sterilization by history

11 Ultrasound non-diagnostic for etiology of pain Testing non-diagnostic for etiology of pain: CT or MRI Diagnostic laparoscopy Treatment: NSAIDS > 4 weeks Depot or oral contraceptive > 8 weeks GnRH agonist > 8 weeks Antibiotic treatment X one course Danazol > 8 weeks Worsening symptoms during IV treatment Continued pain after treatment

12 PELVIC INFLAMMATORY DISEASE/ TUBO-OVARIAN ABCESS Pelvic Inflammatory Disease: Pelvic pain Acute Pelvic Inflammatory Disease > 2 episodes by by H & P exam Infection documented > episode by positive culture Most recent cervical cytology normal (or treated) HCG planned prior to procedure Tubo-Ovarian Abscess: Tubo-ovarian abscess by imaging Ectopic pregnancy excluded by negative HCG Symptoms: Pelvic pain; and/or Abdominal tenderness; and/or Persistent adnexal mass; and/or Temperature > 100.4; and/or WBC > normal Worsening symptoms during IV treatment

13 UTERINE PROLAPSE Uterine prolapse by physical examination Second Degree Third Degree Pelvic pressure by history Pelvic pain by history Stress incontinence by history Ulceration with bleeding or spotting by physical examination Vaginal splinting Most recent cervical cytology normal (or treated) HCG planned prior to procedure; OR Sterilization by history; OR

Perimenopausal DUB. Mary Anne Jamieson, MD Associate Professor, OB/GYN Queen s University Kingston, Ontario

Perimenopausal DUB. Mary Anne Jamieson, MD Associate Professor, OB/GYN Queen s University Kingston, Ontario Perimenopausal DUB Mary Anne Jamieson, MD Associate Professor, OB/GYN Queen s University Kingston, Ontario Objectives Clinicians will: Make a confident diagnosis for Perimenopausal DUB (know how/when to

More information

Dr Mary Birdsall. Fertility Associates Auckland

Dr Mary Birdsall. Fertility Associates Auckland Dr Mary Birdsall Fertility Associates Auckland Period Problems Mary Birdsall Medical Director Fertility Associates Auckland Period Problems Basic Physiology No Periods Irregular Periods Heavy Periods

More information

Heavy Menstrual Bleeding. Mr Nick Nicholas MD FRCOG Grad Dip Law. Consultant Gynaecologist

Heavy Menstrual Bleeding. Mr Nick Nicholas MD FRCOG Grad Dip Law. Consultant Gynaecologist Heavy Menstrual Bleeding Mr Nick Nicholas MD FRCOG Grad Dip Law. Consultant Gynaecologist Why is HMB so important? 1:20 women aged 30-49 consult their GP with HMB Once referred to gynaecologist, surgical

More information

Chronic Pelvic Pain. Bridget Kamen, MD Obstetrics and Gynecology, Confluence Health. I have no disclosures

Chronic Pelvic Pain. Bridget Kamen, MD Obstetrics and Gynecology, Confluence Health. I have no disclosures Chronic Pelvic Pain Bridget Kamen, MD Obstetrics and Gynecology, Confluence Health I have no disclosures Objectives A little epidemiology Understand there are both gynecologic and non-gynecologic causes

More information

Fibroid mapping. Haitham Hamoda MD FRCOG Consultant Gynaecologist, Subspecialist in Reproductive Medicine & Surgery King s College Hospital

Fibroid mapping. Haitham Hamoda MD FRCOG Consultant Gynaecologist, Subspecialist in Reproductive Medicine & Surgery King s College Hospital Fibroid mapping Haitham Hamoda MD FRCOG Consultant Gynaecologist, Subspecialist in Reproductive Medicine & Surgery King s College Hospital Fibroids Common condition >70% of women by onset of menopause.

More information

Chronic Pelvic Pain Case Study

Chronic Pelvic Pain Case Study Case Study Chronic Pelvic Pain Case Study Melissa, a 28 year old veteran comes to your office complaining of lower abdominal pain for the past 6 months. She has tried acetaminophen and ibuprofen but they

More information

My Patient Has Pelvic Pain. David A. Kenny DO

My Patient Has Pelvic Pain. David A. Kenny DO My Patient Has Pelvic Pain David A. Kenny DO Definition Of apparent pelvic origin Present most of the time for at least six months Severe enough to cause functional disability Requiring surgical or medical

More information

PELVIC PAIN IN GYNECOLOGY

PELVIC PAIN IN GYNECOLOGY PELVIC PAIN IN GYNECOLOGY Pelvic pain is an important part of clinical practice for who any clinician who provides health care for women. It can be acute, recurrent or chronic. Differential Diagnosis:

More information

Endometriosis. *Chocolate cyst in the ovary

Endometriosis. *Chocolate cyst in the ovary Endometriosis What is endometriosis? Endometriosis is a common condition in young women. It's chronic, painful, and it often progressively gets worse over the time. *Chocolate cyst in the ovary Normally,

More information

Cervical Cancer - Suspected

Cervical Cancer - Suspected Cervical Cancer - Suspected Presentation for patients Asymptomatic presentation Symptomatic presentation History and examination Consider differential diagnoses RED FLAG! Cervix appears normal after examination

More information

Gynecologic Decision Making Based on Sonographic Findings

Gynecologic Decision Making Based on Sonographic Findings Gynecologic Decision Making Based on Sonographic Findings Mindy Goldman, MD Department of Obstetrics & Gynecology & Vickie A. Feldstein, MD Department of Radiology University of California, San Francisco

More information

Chapter 100 Gynecologic Disorders

Chapter 100 Gynecologic Disorders Chapter 100 Gynecologic Disorders Episode Overview: 1. Describe the presentation and RF for Adnexal torsion 2. List the imaging findings of adnexal torsion (US vs CT) 3. What is the management of adnexal

More information

Conflicts 10/5/2016. Abnormal Uterine Bleeding. Objectives Review diagnosis and updated nomenclature. Management options for acute and chronic AUB.

Conflicts 10/5/2016. Abnormal Uterine Bleeding. Objectives Review diagnosis and updated nomenclature. Management options for acute and chronic AUB. Abnormal Uterine Bleeding Barbara L. Keller, MD JD Naval Hospital Oak Harbor OB/GYN Physician Conflicts I have no conflicts or financial interests to disclose. Objectives Review diagnosis and updated nomenclature.

More information

reproductive organs. Malignant neoplasms. 4. Inflammatory disorders of female reproductive organs 2 5. Infertility. Family planning.

reproductive organs. Malignant neoplasms. 4. Inflammatory disorders of female reproductive organs 2 5. Infertility. Family planning. Thematic plan of lectures module iii. Diseases of female reproductive system. Family planning. Topic No of hours 1. Disturbances of menstrual function. Neuroendocrinological 2 syndromes in gynecology 1.

More information

Palm Beach Obstetrics & Gynecology, PA

Palm Beach Obstetrics & Gynecology, PA Palm Beach Obstetrics & Gynecology, PA 4671 S. Congress Avenue, Lake Worth, FL 33461 561.434.0111 4631 N. Congress Avenue, Suite 102, West Palm Beach, FL 33407 Endometriosis The lining of the uterus is

More information

Frequency of menses. Duration of menses 3 days to 7 days. Flow/amount of menses Average blood loss with menstruation is 60-80cc.

Frequency of menses. Duration of menses 3 days to 7 days. Flow/amount of menses Average blood loss with menstruation is 60-80cc. Frequency of menses 24 days (0.5%) to 35 days (0.9%) Age 25, 40% are between 25 and 28 days Age 25-35, 60% are between 25 and 28 days Teens and women over 40 s cycles may be longer apart Duration of menses

More information

Contents: Benign Diseases of the Uterus

Contents: Benign Diseases of the Uterus COLLEGE OF MEDICINE DEPT. OF OBSTETRICS AND GYNECOLOGY Benign Diseases of the Uterus Dr.Ayman Hussien Shaamash MBBCH, MSc., MD. (Egypt) Professor of OB./Gyn. Faculty of Medicine. King khalid University

More information

Primary Care Gynaecology Guidelines: HEAVY REGULAR MENSTRUAL BLEEDING

Primary Care Gynaecology Guidelines: HEAVY REGULAR MENSTRUAL BLEEDING Primary Care Guidelines: HEAVY REGULAR MENSTRUAL BLEEDING

More information

Endometriosis and Infertility - FAQs

Endometriosis and Infertility - FAQs Published on: 8 Apr 2013 Endometriosis and Infertility - FAQs Introduction The inner lining of the uterus is called the endometrium and it responds to changes that take place during a woman's monthly menstrual

More information

Chronic Pelvic Pain. AP099, December 2010

Chronic Pelvic Pain. AP099, December 2010 AP099, December 2010 Chronic Pelvic Pain Pain in the pelvic area that lasts for 6 months or longer is called chronic pelvic pain. An estimated 15 20% of women aged 18 50 years have chronic pelvic pain

More information

The Centre for Reproductive Medicine HYSTERECTOMY

The Centre for Reproductive Medicine HYSTERECTOMY The Centre for Reproductive Medicine PO Box 20559 Nimbin NSW 2480 Australia Maxwell Brinsmead MB BS PhD MRCOG FRANZCOG Phone + 61 409 870 346 Retired Obstetrician & Gynaecologist E-mail max@brinsmead.net.au

More information

Pelvic Pain. What you need to know. 139 Dumaresq Street Campbelltown Phone Fax

Pelvic Pain. What you need to know. 139 Dumaresq Street Campbelltown Phone Fax Pelvic Pain What you need to know 139 Dumaresq Street Campbelltown Phone 4628 5292 Fax 4628 0349 www.nureva.com.au September 2015 PELVIC PAIN This is a common problem and most women experience some form

More information

Dysmenorrhea. Erin Eppsteiner, M.D. Department of Ob/Gyn The University of Iowa Roy J & Lucille A Carver College of Medicine

Dysmenorrhea. Erin Eppsteiner, M.D. Department of Ob/Gyn The University of Iowa Roy J & Lucille A Carver College of Medicine Dysmenorrhea Erin Eppsteiner, M.D. Department of Ob/Gyn The University of Iowa Roy J & Lucille A Carver College of Medicine Objectives Be able to recognize primary and secondary dysmenorrhea Be familiar

More information

POTION OR POISON? MEDICAL TREATMENT ALTERNATIVES TO THE PILL. Lester Ruppersberger, D.O., FACOOG,CNFPI NFP only Gynecologist

POTION OR POISON? MEDICAL TREATMENT ALTERNATIVES TO THE PILL. Lester Ruppersberger, D.O., FACOOG,CNFPI NFP only Gynecologist POTION OR POISON? MEDICAL TREATMENT ALTERNATIVES TO THE PILL Lester Ruppersberger, D.O., FACOOG,CNFPI NFP only Gynecologist THE PILL Released to US market in 1960 10-15 x dose of hormones in HRT Over 10-14

More information

Laparoscopy and Hysteroscopy

Laparoscopy and Hysteroscopy AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE Laparoscopy and Hysteroscopy A Guide for Patients PATIENT INFORMATION SERIES Published by the American Society for Reproductive Medicine under the direction of

More information

Bursting Pelvic Inflammatory Disease.

Bursting Pelvic Inflammatory Disease. www.infertiltysolutionsng.info/blog Disclaimer The information in this book is provided for educational purposes only and is not intended to treat, diagnose or prevent any disease. The information in this

More information

All referrals for out-patient appointments can also be discussed with the Obstetrics and Gynaecology registrar as necessary. Presence of ascites

All referrals for out-patient appointments can also be discussed with the Obstetrics and Gynaecology registrar as necessary. Presence of ascites Gynaecology Referral Pathway for GPs to Aid Triage for Gynaecology Services in the Rotunda For acute gynaecology (suspected torsion, acute PID, etc..) or acute early pregnancy referrals please consider

More information

Bursting Pelvic Inflammatory Disease.

Bursting Pelvic Inflammatory Disease. www.infertiltysolutionsng.info/blog Disclaimer The information in this book is provided for educational purposes only and is not intended to treat, diagnose or prevent any disease. The information in this

More information

Patient Past Medical History

Patient Past Medical History Patient Past Medical History A. Identifying Data Date this form when completed Your name Partner's name Age Birth date Height Weight Length of marriage (or relationship) How long have you been trying unsuccessfully

More information

MANAGEMENT OF REFRACTORY ENDOMETRIOSIS

MANAGEMENT OF REFRACTORY ENDOMETRIOSIS (339) MANAGEMENT OF REFRACTORY ENDOMETRIOSIS Serdar Bulun, MD JJ Sciarra Professor and Chair Department of Ob/Gyn Northwestern University ENDOMETRIOSIS OCs Teenager: severe dysmenorrhea often starting

More information

FDA-Approved Patient Labeling Patient Information Mirena (mur-ā-nah) (levonorgestrel-releasing intrauterine system)

FDA-Approved Patient Labeling Patient Information Mirena (mur-ā-nah) (levonorgestrel-releasing intrauterine system) FDA-Approved Patient Labeling Patient Information Mirena (mur-ā-nah) (levonorgestrel-releasing intrauterine system) Mirena does not protect against HIV infection (AIDS) and other sexually transmitted infections

More information

6 Week Course Agenda. Today s Agenda. Ovarian Cancer: Risk Factors. Winning the War 11/30/2016 on Women s Cancer Gynecologic Cancer Prevention

6 Week Course Agenda. Today s Agenda. Ovarian Cancer: Risk Factors. Winning the War 11/30/2016 on Women s Cancer Gynecologic Cancer Prevention 6 Week Course Agenda Winning the War 11/30/2016 on Women s Cancer Gynecologic Cancer Prevention Lee-may Chen, MD Director, Division of Gynecologic Oncology Professor Department of Obstetrics, Gynecology

More information

Dr. Nancy Van Eyk Associate Professor, Dalhousie University Chief of Gynaecology, IWK Health Centre

Dr. Nancy Van Eyk Associate Professor, Dalhousie University Chief of Gynaecology, IWK Health Centre Dr. Nancy Van Eyk Associate Professor, Dalhousie University Chief of Gynaecology, IWK Health Centre AUB Outline Terminology Classification/Etiology Assessment Treatment Referral to Gynaecology U c pt 4

More information

Please fill out the following information and have it returned to our office prior to your consultation.

Please fill out the following information and have it returned to our office prior to your consultation. Please fill out the following information and have it returned to our office prior to your consultation. Patient s Name Partner s Name Address: City: State: Zip: Phone (day#): ( ) (eve#) ( ) (cell) ( )

More information

Endometriosis د. نجمه محمود كلية الطب جامعة بغداد فرع النسائية والتوليد

Endometriosis د. نجمه محمود كلية الطب جامعة بغداد فرع النسائية والتوليد Endometriosis د. نجمه محمود كلية الطب جامعة بغداد فرع النسائية والتوليد Objectives:- To know what is endometriosis The sites where it occur To explain its itiology & pathogenesis To know the clinical features

More information

Pelvic Pain: Diagnosis and Management

Pelvic Pain: Diagnosis and Management Pelvic Pain: Diagnosis and Management Mr N Pisal Consultant Gynaecologist Advanced Laparoscopic Surgeon www.london-gynaecology.com History LMP Dysmenorrhoea / Dyspareunia Cyclical pain related to menstrual

More information

What is endometrial cancer?

What is endometrial cancer? Uterine cancer What is endometrial cancer? Endometrial cancer is the growth of abnormal cells in the lining of the uterus. The lining is called the endometrium. Endometrial cancer usually occurs in women

More information

5/5/2010 FINANCIAL DISCLOSURE. Abnormal Uterine Bleeding. Is This A Problem? About me % of visits to gynecologist

5/5/2010 FINANCIAL DISCLOSURE. Abnormal Uterine Bleeding. Is This A Problem? About me % of visits to gynecologist Abnormal Uterine FINANCIAL DISCLOSURE I HAVE NO FINANCIAL INTEREST IN ANY OF THE PRODUCTS MENTIONED IN MY PRESENTATION Bryan K. Rone, M.D. University of Kentucky Obstetrics and Gynecology May 5, 2010 About

More information

Non-contraceptive Uses of the Levonorgestrel Intrauterine Device Elena Gates, MD http://www.mirena-us.com/pvs1/pri/whatisframe.html Progestin levels with LNG- IUS Lower plasma levels Mirena 150-200 pg/ml

More information

Healthcare Education Research

Healthcare Education Research Healthcare Education Research Heavy menstrual bleeding: investigation, diagnosis & management An update for health professionals Assessment of heavy menstrual bleeding in primary care Dr Amanda Newman

More information

PRE TEST CERVICAL SCREENING MANAGEMENT COLPOSCOPY PATHOLOGIC DIAGNOSIS AND TREATMENT

PRE TEST CERVICAL SCREENING MANAGEMENT COLPOSCOPY PATHOLOGIC DIAGNOSIS AND TREATMENT PRE TEST CERVICAL SCREENING MANAGEMENT COLPOSCOPY PATHOLOGIC DIAGNOSIS AND TREATMENT QUESTION #1 WHICH OF THE FOLLOWING IS NOT A RISK FACTOR FOR CERVICAL CANCER? A. HIGH RISK HPV B. CIGARETTE SMOKING C.

More information

Abnormal uterine bleeding:

Abnormal uterine bleeding: Primary Care Women s Health Forum 16th June 2010 Abnormal uterine bleeding: The University Of Birmingham T Justin Clark MD (Hons), MRCOG Consultant Obstetrician and Gynaecologist Birmingham Women s Hospital

More information

Hysterectomy. What is a hysterectomy? Why is hysterectomy done? Are there alternatives to hysterectomy?

Hysterectomy. What is a hysterectomy? Why is hysterectomy done? Are there alternatives to hysterectomy? 301.681.3400 OBGYNCWC.COM What is a hysterectomy? Hysterectomy Hysterectomy is surgery to remove the uterus. It is a very common type of surgery for women in the United States. Removing your uterus means

More information

Laparoscopic Hysterectomy

Laparoscopic Hysterectomy Laparoscopic Hysterectomy A/Professor Alan Lam MBBS (Hons) FRCOG FRACOG Director Laparoscopic hysterectomy Laparoscopic hysterectomy hysterectomy Laparoscopic hysterectomy Laparoscopic Laparoscopic hysterectomy

More information

Gynaecological Oncology Cases

Gynaecological Oncology Cases Gynaecological Oncology Cases 1. Tamoxifen and the endometrium 2. Cancer and the older woman Dr Julie M Lamont Consultant Gynaecological Oncologist Epworth Freemasons Hospital 21 st April 2015 Mrs FS 66

More information

Types of Hysterectomy for Non-cancerous Conditions: Understanding Your Doctor s Recommendations

Types of Hysterectomy for Non-cancerous Conditions: Understanding Your Doctor s Recommendations Types of Hysterectomy for Non-cancerous Conditions: Understanding Your Doctor s Recommendations Who can benefit from this information? The decision to have a hysterectomy is one of the many important decisions

More information

Management of Gynae Problems in Primary Care David Griffiths FRCOG The Great Western Hospital Swindon. A brief overview

Management of Gynae Problems in Primary Care David Griffiths FRCOG The Great Western Hospital Swindon. A brief overview Management of Gynae Problems in Primary Care David Griffiths FRCOG The Great Western Hospital Swindon A brief overview Pelvic Pain Challenge to the physician In UK 1 Million sufferers 20% of all gynae

More information

Abnormal Uterine Bleeding Case Studies

Abnormal Uterine Bleeding Case Studies Case Study 1 Abnormal Uterine Bleeding Case Studies Abigail, a 24 year old female, presents to your office complaining that her menstrual cycles have become a problem. They are now lasting 6 7 days instead

More information

Menstrual Disorders & Ambulatory Gynaecology

Menstrual Disorders & Ambulatory Gynaecology Menstrual Disorders & Ambulatory Gynaecology Mr. Nagui Lewis Aziz M B, CH B, FRCOG Consultant Gynaecologist The Royal Oldham Hospital 01/09/2018 Heavy menstrual bleeding (HMB ) is a common problem responsible

More information

CLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION

CLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION Donald L. Renfrew, MD Radiology Associates of the Fox Valley, 333 N. Commercial Street, Suite 100, Neenah, WI 54956 2/12/2011 Radiology Quiz of the Week # 7 Page 1 CLINICAL PRESENTATION AND RADIOLOGY QUIZ

More information

ORILISSA (elagolix) oral tablet

ORILISSA (elagolix) oral tablet ORILISSA (elagolix) oral tablet Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in the member's specific benefit plan. This Pharmacy Coverage

More information

Pelvic Pain/Endometriosis Year 3 Updated April 2017 By Dr. J. N. Kirby

Pelvic Pain/Endometriosis Year 3 Updated April 2017 By Dr. J. N. Kirby Pelvic Pain/Endometriosis Year 3 Updated April 2017 By Dr. J. N. Kirby Objectives (At the end of this session ) Causes of acute and chronic pelvic pain will be more clear to you Investigations to determine

More information

Moneli Golara Consultant Obstetrician and Gynaecologist Barnet Hospital Royal Free NHS Trust

Moneli Golara Consultant Obstetrician and Gynaecologist Barnet Hospital Royal Free NHS Trust Moneli Golara Consultant Obstetrician and Gynaecologist Barnet Hospital Royal Free NHS Trust Endometriosis one of the most common conditions requiring treatment Growth of endometrial like tissue outside

More information

Gynaecology Cancer Red Flags. Dr Dina Bisson Consultant Obstetrician and Gynaecologist Southmead Hospital North Bristol NHS Trust 27 April 2017

Gynaecology Cancer Red Flags. Dr Dina Bisson Consultant Obstetrician and Gynaecologist Southmead Hospital North Bristol NHS Trust 27 April 2017 Gynaecology Cancer Red Flags Dr Dina Bisson Consultant Obstetrician and Gynaecologist Southmead Hospital North Bristol NHS Trust 27 April 2017 Gynaecological Cancers Endometrial Cancer Ovarian Cancer Cervical

More information

Abnormal Uterine Bleeding: Evaluation of Premenopausal Women. Vanessa Jacoby, MD, MAS Assistant Professor Ob, Gyn, & Reproductive Sciences UCSF

Abnormal Uterine Bleeding: Evaluation of Premenopausal Women. Vanessa Jacoby, MD, MAS Assistant Professor Ob, Gyn, & Reproductive Sciences UCSF Abnormal Uterine Bleeding: Evaluation of Premenopausal Women Vanessa Jacoby, MD, MAS Assistant Professor Ob, Gyn, & Reproductive Sciences UCSF Objectives Define normal and abnormal uterine bleeding Review

More information

CNGOF Guidelines for the Management of Endometriosis

CNGOF Guidelines for the Management of Endometriosis CNGOF Guidelines for the Management of Endometriosis Anatomoclinical forms of endometriosis Definitions Endometriosis is defined as the presence of endometrial tissue containing both glands and stroma

More information

Facing Gynecologic Surgery?

Facing Gynecologic Surgery? Facing Gynecologic Surgery? Domenico Vitobello, MD Domenico Vitobello is the medical director of the Gynecologic Unit at the Humanitas Clinical and Research Center since 2009. He has developed a comprehensive

More information

Endometriosis. A Guide for Patients PATIENT INFORMATION SERIES

Endometriosis. A Guide for Patients PATIENT INFORMATION SERIES Endometriosis A Guide for Patients PATIENT INFORMATION SERIES Published by the American Society for Reproductive Medicine under the direction of the Patient Education Committee and the Publications Committee.

More information

An Update on the Management of Heavy Menstrual Bleeding

An Update on the Management of Heavy Menstrual Bleeding An Update on the Management of Heavy Menstrual Bleeding Sonia WM LAI MBBS, MRCOG SL MOK MBBS SK LAM MBBS, FRCOG Department of Obstetrics and Gynaecology, Kwong Wah Hospital, 25 Waterloo Road, Kowloon,

More information

Gynaecology. Pelvic inflammatory disesase

Gynaecology. Pelvic inflammatory disesase Gynaecology د.شيماءعبداألميرالجميلي Pelvic inflammatory disesase Pelvic inflammatory disease (PID) is usually the result of infection ascending from the endocervix causing endometritis, salpingitis, parametritis,

More information

Dysmenorrhoea Gynaecology د.شيماءعبداالميرالجميلي. Aetiology of secondary dysmenorrhea

Dysmenorrhoea Gynaecology د.شيماءعبداالميرالجميلي. Aetiology of secondary dysmenorrhea 30-11-2014 Gynaecology Dysmenorrhoea د.شيماءعبداالميرالجميلي Dysmenorrhoea is defined as painful menstruation. It is experienced by 45 95 per cent of women of reproductive age.primary Spasmodic Dysmenorrhea

More information

Endometriosis. A Guide for Patients PATIENT INFORMATION SERIES

Endometriosis. A Guide for Patients PATIENT INFORMATION SERIES Endometriosis A Guide for Patients PATIENT INFORMATION SERIES Published by the American Society for Reproductive Medicine under the direction of the Patient Education Committee and the Publications Committee.

More information

MPH Quiz. 1. How many primaries are present based on this pathology report? 2. What rule is this based on?

MPH Quiz. 1. How many primaries are present based on this pathology report? 2. What rule is this based on? MPH Quiz Case 1 Surgical Pathology from hysterectomy performed July 11, 2007 Final Diagnosis: Uterus, resection: Endometrioid adenocarcinoma, Grade 1 involving most of endometrium, myometrial invasion

More information

RANZCOG Advanced Training Modules

RANZCOG Advanced Training Modules RANZCOG Advanced Training Modules Generalist Obstetrics ATM and Generalist Gynaecology ATM The Generalist ATMs in each of Obstetrics and Gynaecology provide a framework for trainees to consolidate and

More information

Molly A. Brewer DVM, MD, MS Chair and Professor Department of Obstetrics and Gynecology University of Connecticut School of Medicine

Molly A. Brewer DVM, MD, MS Chair and Professor Department of Obstetrics and Gynecology University of Connecticut School of Medicine Molly A. Brewer DVM, MD, MS Chair and Professor Department of Obstetrics and Gynecology University of Connecticut School of Medicine Review causes of abnormal uterine bleeding: Adolescent Reproductive

More information

Elaina Sexton, MD, MSc Obstetrics and Gynecology St. Vincent s Hospital. Objectives

Elaina Sexton, MD, MSc Obstetrics and Gynecology St. Vincent s Hospital. Objectives Elaina Sexton, MD, MSc Obstetrics and Gynecology St. Vincent s Hospital Objectives Definition of normal menstrual cycle and abnormal uterine bleeding (AUB) Evaluation of AUB Medical options for AUB Surgical

More information

Subject Index. Cavaterm, endometrial ablation complications 146, 150 contraindications 152 cost analysis compared with hysterectomy

Subject Index. Cavaterm, endometrial ablation complications 146, 150 contraindications 152 cost analysis compared with hysterectomy OOOOOOOOOOOOOOOOOOOOOOOOOOOOOO Subject Index Abnormal uterine bleeding, see also Adenomyosis, Endometrial cancer, Menorrhagia dilatation and curettage 21, 22, 25 hysteroscopy of premenopausal women anesthesia

More information

Ardhanu Kusumanto Oktober Contraception methods for gyne cancer survivors

Ardhanu Kusumanto Oktober Contraception methods for gyne cancer survivors Ardhanu Kusumanto Oktober 2017 Contraception methods for gyne cancer survivors Background cancer treatment Care of gyn cancer survivor Promotion of sexual, cardiovascular, bone, and brain health management

More information

ADENOMYOSIS CHRONIC PELVIC PAIN IN WOMEN IMAGING CHRONIC PELVIC PAIN IN WOMEN CHRONIC PELVIC PAIN IN WOMEN ADENOMYOSIS: PATHOLOGY ADENOMYOSIS

ADENOMYOSIS CHRONIC PELVIC PAIN IN WOMEN IMAGING CHRONIC PELVIC PAIN IN WOMEN CHRONIC PELVIC PAIN IN WOMEN ADENOMYOSIS: PATHOLOGY ADENOMYOSIS CHRONIC PELVIC PAIN IN WOMEN IMAGING CHRONIC PELVIC PAIN IN WOMEN MOSTAFA ATRI, MD Dipl. Epid. UNIVERSITY OF TORONTO Non-menstrual pain of 6 months Prevalence 15%: 18-50 years of age 10-40% of gynecology

More information

Pelvic Inflammatory Disease (PID) Max Brinsmead PhD FRANZCOG July 2011

Pelvic Inflammatory Disease (PID) Max Brinsmead PhD FRANZCOG July 2011 Pelvic Inflammatory Disease (PID) Max Brinsmead PhD FRANZCOG July 2011 This talk What is Pelvic Inflammatory Disease? Why it is important How it is spread Diagnosis Treatment Prevention What is PID? Inflammation

More information

Surgery to Reduce the Risk of Ovarian Cancer. Information for Women at Increased Risk

Surgery to Reduce the Risk of Ovarian Cancer. Information for Women at Increased Risk Surgery to Reduce the Risk of Ovarian Cancer Information for Women at Increased Risk Centre for Genetics Education NSW Health 2017 The Centre for Genetics Education NSW Health Level 5 2C Herbert St St

More information

Uterine-Sparing Treatment Options for Symptomatic Uterine Fibroids

Uterine-Sparing Treatment Options for Symptomatic Uterine Fibroids Uterine-Sparing Treatment Options for Symptomatic Uterine Fibroids Developed in collaboration Learning Objective Upon completion, participants should be able to: Review uterine-sparing fibroid therapies

More information

DIP.G.O. EXAMINATION 2007

DIP.G.O. EXAMINATION 2007 DIP.G.O. EXAMINATION 2007 GYNAECOLOGY Batch A/07 Time : 2 hrs. Question 1. a. Define Dysfunctional Uterine Bleeding 10 b. What are the various terms used to describe menstrual disorder? 10 Question 2.

More information

FEMALE PATIENT HISTORY

FEMALE PATIENT HISTORY ew Hope. ew Life. ew Beginnings. A Division of MID-ATLATIC WOME S CARE, PLC FEMALE PATIET HISTORY PLEASE OTE: Infertility patients please complete ALL sections. All other patients, complete section 1.,

More information

REFERRAL GUIDELINES: GYNAECOLOGY

REFERRAL GUIDELINES: GYNAECOLOGY All patients referred to specialist clinics are assigned to a priority category based on their clinical need and related psychosocial factors. The examples given are indicative only and the clinician reviewing

More information

What s New in Adolescent Contraception?

What s New in Adolescent Contraception? What s New in Adolescent Contraception? Abby Furukawa, MD Legacy Medical Group Portland Obstetrics and Gynecology April 29, 2017 Objectives Provide an update on contraception options for the adolescent

More information

Endometriosis BRADEN COLEMAN, MD PGY-3

Endometriosis BRADEN COLEMAN, MD PGY-3 Endometriosis BRADEN COLEMAN, MD PGY-3 Case 1: 30 y/o F PMH Borderline personality disorder, anxiety, depression, presents with complaints of LLQ abdominal pain and palpable abdominal nodules. She reports

More information

Gynecologic Cancers are many diseases. Gynecologic Cancers in the Age of Precision Medicine Advances in Internal Medicine. Speaker Disclosure:

Gynecologic Cancers are many diseases. Gynecologic Cancers in the Age of Precision Medicine Advances in Internal Medicine. Speaker Disclosure: Gynecologic Cancer Care in the Age of Precision Medicine Gynecologic Cancers in the Age of Precision Medicine Advances in Internal Medicine Lee-may Chen, MD Department of Obstetrics, Gynecology & Reproductive

More information

Gynecologic Cancers are many diseases. Speaker Disclosure: Gynecologic Cancer Care in the Age of Precision Medicine. Controversies in Women s Health

Gynecologic Cancers are many diseases. Speaker Disclosure: Gynecologic Cancer Care in the Age of Precision Medicine. Controversies in Women s Health Gynecologic Cancer Care in the Age of Precision Medicine Gynecologic Cancers in the Age of Precision Medicine Controversies in Women s Health Lee-may Chen, MD Department of Obstetrics, Gynecology & Reproductive

More information

Patient Health Forms

Patient Health Forms Patient Health Forms All forms MUST be completed and signed prior to seeing the Provider First: M: Last: Email Address: Home Address: Best Phone Number to Reach You: Last 4 of your social security #: Marital

More information

GYNAECOLOGY AUDIT FORM I. Principles in coding diagnosis

GYNAECOLOGY AUDIT FORM I. Principles in coding diagnosis GYNAECOLOGY AUDIT FORM 2019 I. Principles in coding diagnosis 1. If an operation was performed on the patient, the pathological diagnosis should be coded. If an operation was not performed, the MOST PROBABLE

More information

Laparoscopy-Hysteroscopy

Laparoscopy-Hysteroscopy Laparoscopy-Hysteroscopy Patient Information Laparoscopy The laparoscope, a surgical instrument similar to a telescope, is inserted through a small incision (cut) in the belly button during laparoscopy.

More information

Aulia Rahman, S. Ked Endang Sri Wahyuni, S. Ked Nova Faradilla, S. Ked

Aulia Rahman, S. Ked Endang Sri Wahyuni, S. Ked Nova Faradilla, S. Ked Authors : Aulia Rahman, S. Ked Endang Sri Wahyuni, S. Ked Nova Faradilla, S. Ked Faculty of Medicine University of Riau Pekanbaru, Riau 2009 Files of DrsMed FK UR (http://www.files-of-drsmed.tk 0 INTTRODUCTION

More information

Fibroids. Very Common! Benign smooth muscle tumors of the myometrium 20-80% of women develop fibroids by age 50* 151 million women affected**

Fibroids. Very Common! Benign smooth muscle tumors of the myometrium 20-80% of women develop fibroids by age 50* 151 million women affected** Fibroids Very Common! Benign smooth muscle tumors of the myometrium 20-80% of women develop fibroids by age 50* 151 million women affected** * Uterine Fibroids Fact Sheet Office on Women s Health 2015

More information

The Role of Imaging for Gynecologic Emergencies

The Role of Imaging for Gynecologic Emergencies Objectives The Role of Imaging for Gynecologic Emergencies M. Jonathon Solnik, MD, FACOG FACS Associate Professor of Obstetrics & Gynaecology Head of Gynaecology & Minimally Invasive Surgery University

More information

Question Bank III - BHMS

Question Bank III - BHMS Question Bank III - BHMS Sub:- Ob/Gy -Paper-II 1. Give the definition of Puberty. 2. Enumerate five important physical changes evident during puberty. 3. Write down the vaginal changes during puberty.

More information

Heavy menstrual bleeding: assessment and management

Heavy menstrual bleeding: assessment and management Heavy menstrual bleeding: assessment and management NICE guideline Draft for consultation, August 0 This guideline covers assessing and treating heavy menstrual bleeding. It aims to help healthcare professionals

More information

Endometriosis. What you need to know. 139 Dumaresq Street Campbelltown Phone Fax

Endometriosis. What you need to know. 139 Dumaresq Street Campbelltown Phone Fax Endometriosis What you need to know 139 Dumaresq Street Campbelltown Phone 4628 5292 Fax 4628 0349 www.nureva.com.au September 2015 What is Endometriosis? Endometriosis is a condition whereby the lining

More information

Endometriosis. Assoc.Prof.Pawin Puapornpong, Faculty of Medicine, Srinakharinwirot University.

Endometriosis. Assoc.Prof.Pawin Puapornpong, Faculty of Medicine, Srinakharinwirot University. Endometriosis Assoc.Prof.Pawin Puapornpong, Faculty of Medicine, Srinakharinwirot University. Endometriosis Definition: Ectopic Endometrial Tissue True Incidence Unknown:? 1-5% Does NOT Discriminate by

More information

University Gynecologic Oncology Associates

University Gynecologic Oncology Associates University Gynecologic Oncology Associates Medical History Form Date: Name: Date of Birth: / / GYNE HISTORY Age of first period? If you no longer have periods, at what age did they stop? Are you pregnant

More information

Acute Salpingitis. Fallopian Tubes. Uterus

Acute Salpingitis. Fallopian Tubes. Uterus Acute Salpingitis Introduction Acute salpingitis is a type of infection that affects the Fallopian tubes. The Fallopian tubes carry eggs from the ovaries to the uterus. Acute salpingitis is one of the

More information

NEW PATIENT DATA SHEET Please complete as best you can. It is not necessary to have all information before speaking with a doctor. PATIENT INFORMATION

NEW PATIENT DATA SHEET Please complete as best you can. It is not necessary to have all information before speaking with a doctor. PATIENT INFORMATION NEW PATIENT DATA SHEET Please complete as best you can. It is not necessary to have all information before speaking with a doctor. PATIENT INFORMATION PATIENT NAME DOB AGE PARTNER NAME DOB AGE STREET CITY

More information

REPRODUCTIVE ENDOCRINOLOGY

REPRODUCTIVE ENDOCRINOLOGY REPRODUCTIVE ENDOCRINOLOGY FERTILITY AND STERILITY VOL. 76, NO. 2, AUGUST 2001 Copyright 2001 American Society for Reproductive Medicine Published by Elsevier Science Inc. Printed on acid-free paper in

More information

PATIENT INFORMATION HANDOUT Dr Joseph K Johnson KG Medical Centre

PATIENT INFORMATION HANDOUT Dr Joseph K Johnson KG Medical Centre PATIENT INFORMATION HANDOUT Dr Joseph K Johnson KG Medical Centre Chronic Pelvic Pain What is Chronic Pelvic Pain? Chronic pelvic pain refers to pain in the lower half of your abdomen, lasting six months,

More information

Excessive menstrual blood loss

Excessive menstrual blood loss Ian Chilcott Excessive menstrual blood loss >80mls - That interferes with physical, emotional, social and material quality of life 1 in 20 women aged 30 to 49 years consult their GP each year with menorrhagia

More information

of AUB DISCLOSURES 10/29/2018

of AUB DISCLOSURES 10/29/2018 of AUB DR. DEBRA GIERUT MD DEPARTMENT OF OBSTETRICS AND GYNECOLOGY KAISER PERMANENTE, ORANGE COUNTY DISCLOSURES I have no financial disclosures Lisa Samerdyke, the Director of National Accounts for Hologic

More information

Product Information. Confidence that lasts

Product Information. Confidence that lasts Confidence that lasts What is Mirena? Inhibition of sperm motility and function inside the uterus and the fallopian tubes, preventing fertilization (Videla-Rivero et al. 1987). Section of system Levonorgestrel

More information

Essure By Mayo Clinic staff

Essure By Mayo Clinic staff Page 1 of 5 Reprints A single copy of this article may be reprinted for personal, noncommercial use only. Essure By Mayo Clinic staff Original Article: http://www.mayoclinic.com/health/essure/my00999 Definition

More information

Please complete prior to the webinar. HOSPITAL REGISTRY WEBINAR FEMALE REPRODUCTIVE SYSTEM EXERCISES CASE 1: FEMALE REPRODUCTIVE

Please complete prior to the webinar. HOSPITAL REGISTRY WEBINAR FEMALE REPRODUCTIVE SYSTEM EXERCISES CASE 1: FEMALE REPRODUCTIVE Please complete prior to the webinar. HOSPITAL REGISTRY WEBINAR FEMALE REPRODUCTIVE SYSTEM EXERCISES PHYSICAL EXAMINATION CASE 1: FEMALE REPRODUCTIVE 3/5 Patient presents through the emergency room with

More information